Almost all of us have at one time or another experienced heartburn, a pain in the mid-chest that actually has nothing to do with the heart (though it can mimic heart attack pain). If we’re lucky, it’s mild and occasional, the obvious result of recent overindulging. But for more than 8 percent of Americans, heartburn is a searingly painful and sometimes daily occurrence, and the numbers tell the story of just how much we’re hurting: Americans spend more than $13 billion a year on prescription drugs for this condition, and more than $3 billion on over-the-counter heartburn remedies. Heartburn that occurs at least twice a week is the primary symptom of gastroesophageal reflux disease, aka GERD. It happens when the lower esophageal sphincter (LES), a ring-shaped valve between the esophagus and stomach, becomes lax, allowing highly acidic stomach contents to back up into the esophagus. This can cause discomfort because the esophagus doesn’t have the same acid-resistant lining as the stomach. Surprisingly, you can have GERD without experiencing heartburn. Some people simply aren’t sensitive to the presence of acid in the esophagus. As a result they can unknowingly be developing damage there; this can sometimes lead to Barrett’s esophagus, a precancerous condition. Other symptoms that can indicate GERD are bad breath, a chronic dry cough, hoarse or raspy voice, lump-in-the-throat sensation and asthma.
Why we’re in pain
Heartburn and GERD cases have risen sharply in the last 30 years. While better diagnostics may be partially responsible, our 21st century way of eating undoubtedly has a lot to do with why so many of us are suffering. “The higher incidence of obesity in our society is one of the major causes,” says Victor S. Sierpina, M.D., a professor of family and integrative medicine at the University of Texas Medical Branch in Galveston and author of The Healthy Gut Workbook (New Harbinger Publications). As we put on weight, he explains, we develop increased pressure in the abdomen, making reflux more likely. Research shows that obese people are more than twice as likely to have a defective LES and suffer from more frequent and more severe GERD than the general population. Our eating habits are also responsible. Over-scheduled, we grab “meals” on the run, often relying on fatty fast food. Cuisines like Indian, Thai and Mexican have become dietary favorites, and spicy as well as highfat foods often trigger heartburn. We’re an aging population as well, and heartburn increases with age. But even young people are affected, due at least in part to the rise in eating disorders. “People who induce vomiting, or have in the past, can have an increased risk of heartburn,” says Jacqueline L. Wolf, M.D., an associate professor of medicine at Harvard Medical School and author of A Woman’s Guide to a Healthy Stomach (Harlequin Nonfiction). While it’s tempting to resort to acidblocking medications, they’re not for longterm use and can pose serious risks (see “The Downsides of Drugs,” below). Before asking your doctor for a prescription or picking something off the drugstore shelf, try these lifestyle changes and natural remedies that can help you avoid GERD in the first place and relieve symptoms if you do develop it. Integrative experts agree: Nailing down the source of your problem is the first step.